NEUROBIOLOGY OF PTSD: THE EFFECTS OF TRAUMATIC STRESS ON THE BRAIN AND THE EFFICACY OF COGNITIVE-BEHAVIORAL THERAPY

Abstract

Post-traumatic stress disorder (PTSD) is a complex psychological condition characterized by symptoms of re-experiencing, avoidance, and hypervigilance, representing a significant clinical and neurobiological challenge. This study aims to understand how the neurobiological alterations associated with PTSD—especially amygdala hyperactivity and hypofunction of the prefrontal cortex and hippocampus—influence the biopsychosocial functioning of the individual, as well as to analyze how Cognitive-Behavioral Therapy (CBT) acts in the modulation of these neural circuits. The methodology adopted was an integrative literature review conducted in the SciELO, BVS, LILACS, MEDLINE, and Google Scholar databases, encompassing publications from 2010 to 2025, in Portuguese and English. The descriptors “PTSD”, “Brain Response”, “Psychological Trauma”, “Neurobiology of Stress”, and “Cognitive-Behavioral Therapy” were used, strategically combined to optimize the search. Peer-reviewed articles, clinical trials, systematic reviews, and meta-analyses that addressed CBT as the main intervention and presented neurobiological or behavioral data related to the trauma response were included. Studies with associated psychiatric comorbidities, unclear methodologies, or lack of peer review were excluded. The results indicate that PTSD involves dysregulation of the stress response system, with dysfunctions in the integration between emotional and cognitive structures. It has been shown that CBT promotes adaptive neuroplasticity, reducing amygdala hyperactivity and increasing the function and connectivity of the prefrontal cortex, favoring emotional control and fear extinction. It is concluded that CBT not only alleviates the clinical symptoms of PTSD, but also modifies neural circuits altered by trauma, integrating advances in neuroscience into psychotherapy and reinforcing its effectiveness as a therapeutic approach.